Electrode dysfunctions in patients with deep brain stimulation: a clinical retrospective study

Abstract

Technical dysfunctions of stimulation electrodes or extension leads are rare but important sources of unsatisfying DBS efficacy. In the majority of cases DBS programming or reprogramming allows avoiding surgical revision.

Variation in Deep Brain Stimulation Electrode Impedance over Years Following Electrode Implantation

“…Therapy impedance represents the resistance to current flow for the specific stimulation parameters being used to treat the patient. Electrode impedance is measured at standardized stimulation parameters and is monitored clinically because abnormal values may indicate electrode dysfunction such as a short or open circuit [11]. Impedance varies significantly between patients and has a substantial effect on the extent of tissue activation, as it affects the amount of current being delivered to the brain.…”

Switching from constant voltage to constant current in deep brain stimulation: a multicenter experience of mixed implants for movement disorders

“… showed that 20% of patients reported a worsening of clinical conditions although there was no evidence of technical problems; it was suggested that the decrease in symptom control was related to an altered current flow at the active contacts, with a consequent change in the volume of activated tissue. In our series the percentage of reported worsening was lower than that reported in the previous studies , and the rate of electrode dysfunction of 5%, corresponding to one case, was lower than that reported in the Allert et al . study .…”

An Experimental Study of Deep Brain Stimulation Lead Fracture: Possible Fatigue Mechanisms and Prevention Approach

“…Placing the connector high on the head is proposed . Clinical retrospective studies have reported that lead fracture is rare with this technique . This procedure might increase the incidence of infection or skin erosion if the connector is too bulky ; however, this can be avoided by lowering the profile of the connector and/or using specific surgical techniques, such as drilling a trough or avoiding putting the connector directly under the suture line .…”